Why daytime teeth clenching can be much worse than sleep bruxism

by Ruth Nichol / 03 October, 2017
RelatedArticlesModule - Daytime teeth grinding

Photo/Getty Images

Daytime teeth clenching or grinding can be harmful – and yet many people don’t realise they’re doing it. 

Many of us clench or grind our teeth occasionally, particularly when we’re stressed or anxious. But one in five people spends long periods every day with their teeth clenched, usually without realising they are doing it.

And although what’s known as daytime (or awake) bruxism is generally seen as less of a problem than its night-time manifestation, sleep bruxism, University of Otago professor of orthodontics Mauro Farella disagrees.

About 8% of adults grind their teeth while asleep, often so loudly that other people can hear it. Farella says in a small number of cases it can eventually start to wear down teeth or damage expensive restorations, such as crowns and implants.

In those cases, the problem can be solved by wearing a mouthguard custom-made by a dentist – though definitely not a cheapie from a pharmacy, which can cause problems with the bite. “There’s a tendency to buy ‘do-it-yourself’ mouthguards, which can have negative consequences for oral health. I strongly discourage anyone from doing that.”

Some people stop night-time teeth-grinding once they give up smoking, cut back on alcohol and coffee or get treatment for acid reflux, all of which are associated with sleep bruxism.

But Farella believes daytime teeth clenching deserves more attention from the dental profession. He says it can cause a range of problems, including masticatory muscle pain – pain in the muscles that control jaw movement – headaches, jaw clicking and, in some cases, a visible increase in the size of the jaw muscles.

“Most people are more concerned with sleep bruxism. It’s considered more scary and more harmful, and most dentists would say it is worse. But I believe the opposite – that daytime bruxism can be more harmful.”

Professor Mauro Farella.

Although night-time teeth grinding can sound alarming to those unfortunate enough to hear it, it generally occurs in short bursts. Farella, who has a long-standing research interest in bruxism, says most people do it for less than 10 minutes a night and not always every night. Daytime teeth clenching, on the other hand, is less intense, but it can continue for longer periods and is often more constant.

“If you clench very hard, you can only do it for a short time. But if you are only lightly clenching, you can do it for minutes or hours, and this is what is worse.”

Between 12% and 14% of people experience masticatory muscle pain, which they describe as aching, stabbing, dull or pressing. More women than men experience it and they’re also more likely to seek treatment. The pain is most common in those aged 20 to 40 and it tends to diminish with age.

Daytime bruxism isn’t the only cause of the pain. Other possible causes include physical trauma to the face or stressful life events such as a death in the family. However, Farella says daytime bruxism is a significant cause of masticatory muscle pain, and breaking the clenching habit can often resolve the problem. If the pain has been present for less than six months, this can be done through simple cognitive behavioural techniques, such as using Post-it notes to remind a person to stop – or doing the modern equivalent and downloading an anti-clenching app to a smartphone.

The diagnostic tool being developed to monitor jaw contractions.

But before people can stop clenching their teeth, they need to recognise they are doing it. Unlike sleep bruxism, daytime bruxism is a silent activity and most people do it unconsciously.

“When I ask patients, ‘Do you clench your teeth?’, they usually say, ‘No, I don’t think so.’”

Until recently, dentists have had to rely on self-monitoring by patients to find out how often – and when – they clench or grind their teeth. But a diagnostic tool being developed by Farella and a University of Otago research team will remove the guesswork.

It’s a small patch that is attached to the cheek to monitor jaw contractions and can be connected wirelessly to a smartphone to provide real-time data on both daytime and sleep bruxism.

“At the moment we have to rely on self-reporting. This device will provide accurate information about how often, how long and how strongly the muscles contract.”

This article was first published in the August 19, 2017 issue of the New Zealand Listener.

MostReadArticlesCollectionWidget - Most Read - Used in articles
AdvertModule - Advert - M-Rec / Halfpage

Latest

Win a double pass to Waru
81958 2017-10-24 00:00:00Z Win

Win a double pass to Waru

by The Listener

From eight Māori women directors come eight connected stories, each taking place at the same time during the tangi of a small boy, Waru.

Read more
When Sir Bob Jones met Muhammad Ali
81845 2017-10-23 00:00:00Z Books

When Sir Bob Jones met Muhammad Ali

by Bob Jones

A new biography finds fault with the legendary fighter, but praise wins by a mile.

Read more
Announcing the finalists of the NZ Craft Awards 2017
81876 2017-10-23 00:00:00Z Culture

Announcing the finalists of the NZ Craft Awards 20…

by NZTV Craft Awards

The finalists of the New Zealand Craft Awards have been announced and here is the complete list.

Read more
Hand, foot and mouth disease is not nearly as scary it seems
81868 2017-10-23 00:00:00Z Health

Hand, foot and mouth disease is not nearly as scar…

by Ruth Nichol

It sounds alarmingly like foot and mouth disease, but all they have in common is they are viral.

Read more
What to do in Auckland if you're a local who wants the tourist experience
81902 2017-10-23 00:00:00Z Travel

What to do in Auckland if you're a local who wants…

by Pamela Wade

After living in Auckland for almost 25 years, Pamela Wade decides to reacquaint herself with the city where she still feels like a stranger.

Read more
The Lesley Calvert cold case: 40 years of torment
80160 2017-10-22 00:00:00Z Crime

The Lesley Calvert cold case: 40 years of torment

by Chris Birt

The mum-of-three was found on a hillside in sight of her farmhouse where she'd disappeared 7 months earlier. Suspicions swirled, but no answers found.

Read more
When I went to Rimutaka Prison for a three-course meal
81858 2017-10-22 00:00:00Z Food

When I went to Rimutaka Prison for a three-course …

by Lauraine Jacobs

A three-course meal inside prison walls proves a rewarding experience for food columnist Lauraine Jacobs.

Read more
The Lundy murders: Inside the case that gripped the nation for 17 years
81945 2017-10-21 07:23:00Z Crime

The Lundy murders: Inside the case that gripped th…

by Anne Marie May

A court reporter who's covered both of Mark Lundy's High Court trials looks at how the case has evolved, as the Court of Appeal deliberates his fate.

Read more